Dental Bridges

What is a dental bridge?

Dental bridges replace missing teeth. Specifically, they can replace one tooth or a row of missing teeth.

As the name implies, this appliance literally “bridges the gap” in your smile. Dentists can create custom bridges that match the shade of your natural teeth.

There are different parts that make up a dental bridge:

• Abutments are the structures that support your dental bridge. While the term often refers to natural teeth, it can also refer to tiny connector posts used in dental implant-supported bridges.
• Pontics are the artificial (false) teeth that fill in the gap left behind by missing teeth.

Depending on your situation and the type of bridge you receive, your bridge might consist of one or more abutments and one or more pontics.

Types of dental bridges

Dentists use different types of bridges based on your oral health goals. The main four types of dental bridges include:

1. Traditional dental bridge. This is the most common type of dental bridge. It consists of dental crowns (caps) on both ends with pontics (artificial teeth) in between. A dentist bonds the crowns to your natural teeth (abutments) on either side of the gap, and the artificial teeth (pontics) fill in the space between. Dentists use traditional dental bridges when you have healthy natural teeth on both sides of the gap.
2. Cantilever dental bridge. A cantilever bridge is similar to a traditional bridge. But there’s only a crown on one end, not both. So, when your dentist bonds the bridge onto your abutment tooth, the artificial tooth (pontic) “hangs over” or extends across the gap. Dentists use cantilever bridges when you only have natural teeth on one side of the gap. Due to their design, cantilever bridges aren’t as strong as traditional bridges.
3. Maryland dental bridge. A Maryland bridge (or resin-bonded bridge) uses metal wings instead of crowns to secure your bridge. A dentist bonds the wings to the backs of your neighboring teeth to hold your bridge in place. Dentists typically use Maryland bridges to replace front teeth. These appliances aren’t strong enough to withstand the chewing forces of back teeth.
4. Implant-supported bridge. An implant-supported bridge is similar to a traditional bridge, but it rests atop dental implants instead of natural teeth. Dental implants are small threaded posts that replace missing teeth roots. Before attaching a bridge to dental implants, your implants must fully integrate (fuse) with your jawbone. This process takes three to six months on average, but it can take longer depending on your situation. Dentists can use implant-supported bridges when you have three or more missing teeth in a row.

To determine what type of bridge you need, a dentist will consider several factors, including:

• Your age. (Dentists typically don’t place bridges in children.)
• How many teeth you’re missing.
• The size of the gap.
• The condition of your teeth next to the gap.
• Whether you have natural teeth on both sides of the gap.
• The overall health of your teeth and gums.
• Your personal preferences.

What happens during a dental bridge procedure?

It depends on what type of dental bridge you receive:

Traditional or cantilever bridge

To place a traditional or cantilever bridge, your dentist will:

1. Give you local anesthesia to keep you comfortable during your dental bridge procedure.
2. Reshape your abutment teeth (the natural teeth that’ll support your new bridge). To do this, they’ll need to remove some tooth enamel. This step is irreversible.
3. Take dental impressions and send them to a dental laboratory. There, a lab technician will use them to create your final bridge.
4. Place a temporary bridge until a lab creates your final bridge. It usually takes about two to four weeks to make a dental bridge.

During a second office visit (once your final bridge is ready), your dentist will:

1. Remove your temporary dental bridge.
2. Try on your new final bridge and check the fit.
3. Bond (cement) your new dental bridge in place.

Some dentists use CAD/CAM (computer-aided design and computer-aided manufacturing) technology to create custom bridges in their office during the same appointment. Ask your dentist if this is a possibility for you.

Maryland bridge

To place a Maryland bridge, your dentist will:

• Prepare your teeth for the metal wings.
• Take dental impressions and send them to a laboratory. (A lab technician will use these to make your final dental bridge.)

Once your final bridge is ready, your dentist will schedule a second office visit. During this appointment, they’ll:

• Try in your new Maryland bridge and check the fit.
• Apply dental etch to the back surfaces of your neighboring (abutment) teeth. This allows for bonding of the dental cement.
• Bond the wings of the Maryland bridge to the backs of your abutment teeth using dental resin cement.

Implant-supported bridge

An implant-supported bridge requires several office visits, including one surgery appointment.

During the first appointment, a dentist, periodontist or oral surgeon will:

• Give you anesthesia to numb your mouth and keep you comfortable.
• Place dental implants into your jaw during an oral surgery procedure.

After surgery, your implants will need to heal and fuse to your jawbone (a process known as osseointegration). This process takes three to six months on average, but it could take longer depending on your situation.

Once your dental implants have integrated (fused), your dentist will:

• Attach impression copings to your dental implants and take dental impressions. (Impression copings are tiny connector posts that extend slightly beyond your gum line.)
• Take dental impressions with the copings in place. They’ll send the impressions to a dental lab.
• Remove the abutments while you wait for the lab to make your new implant-supported bridge.

Once your final implant-supported bridge is ready, your dentist will:

• Place the implant abutments and attached bridge to your dental implants and confirm the fit.
• Secure your bridge in place. Your dentist may use dental cement or tiny screws to do this. (It shouldn’t hurt, though.)

Because dental implants take a few months to integrate (fuse) with your jaw, implant-supported bridges take longer than other types of bridges.

What are the pros and cons of a dental bridge?

Dental bridges offer many benefits. But there are some drawbacks, too:

Advantages of dental bridges

Dental bridges can:

• Offer a natural-looking solution for tooth loss.
• Restore chewing and speech function (missing teeth can make it difficult to eat or speak properly).
• Prevent neighboring teeth from shifting into the gap left behind by missing teeth.

Disadvantages of dental bridges

Dental bridges also have some drawbacks:

• If decay or trauma results in damage to your abutment teeth, it can weaken your dental bridge.
• If your abutment teeth aren’t strong enough to support your bridge, they can fracture.
• If you don’t properly clean the bridge and underlying gum tissue, plaque and bacteria can cause gum inflammation or cavities.

How long does it take to recover after a dental bridge procedure?

Recovery times vary from person to person and depend on several factors. On average, it takes one to two weeks for your teeth and gums to heal. But it can take a little longer for your new dental bridge to feel totally natural and comfortable.

How long does a dental bridge last?

On average, the lifespan of a dental bridge is five to 15 years. Some can last even longer with proper care and maintenance.

You may hear dentists call these “permanent bridges.” They’re permanent in the sense that only a dentist can remove them. But they don’t last forever. You’ll still need to replace them when they show signs of wear or damage.

How can I care for my dental bridge?

Caring for a dental bridge is similar to caring for your natural teeth. To keep your bridge in good condition:

• Brush and floss daily.
• Use a nonabrasive fluoride toothpaste.
• Clean underneath your bridge every day using floss threaders or interproximal brushes (tiny brushes made to go between your teeth).
• Avoid extremely hard or chewy foods.
• Don’t chew on ice, pens, pencils or your fingernails.
• Visit your dentist regularly for checkups and cleanings.

When should I call my dentist?

You should schedule an appointment with your dentist if:

• Your bridge is loose or has visible cracks.
• You have pain when chewing.
• You develop teeth sensitivity or sore, bleeding gums.

Dental bridge vs. implant: Which is better?

In general, dental implants last much longer than bridges. Implants also preserve existing bone and reduce the risk of bone loss in the future.

However, everyone has unique oral health needs, goals and preferences. To determine which treatment option is best for you, talk to your dentist.

What’s the ideal age for a dental bridge?

Most dentists don’t place dental bridges in people younger than 17 or 18, but there are exceptions. For example, a dentist may place a Maryland bridge if a child loses a permanent tooth. Even then, other options may work better, such as a temporary partial denture (sometimes called a “flipper”).

How many teeth can be on a bridge?

Most commonly, a dental bridge replaces one to three teeth in a row. In some cases, a bridge can replace up to four consecutive teeth. But keep in mind, longer bridges usually require more support. So, to replace four missing teeth with a bridge, you need healthy natural teeth on both sides of the gap.

To learn more about your teeth replacement options, talk to a dentist.

How long can you wait to get a dental bridge?

In general, you should replace missing teeth as soon as possible to prevent other teeth from shifting into the gap. However, if you need tooth extraction first, you might have to wait a few months before getting your dental bridge. This gives your gums and underlying bone time to heal.

Is a dental bridge painful?

Getting a dental bridge shouldn’t hurt. Your dentist will give you local anesthesia to numb your gums before beginning your procedure.

Do bridges feel like real teeth?

It can take some time to get used to your new dental bridge. But once you do, it should feel similar to your natural teeth. It’s like wearing a new ring on your finger. You’re aware of it for a while, but you eventually grow accustomed to it.

Can a dental bridge be removed and recemented?

It depends. If your bridge is already loose, it’s usually easy to remove. Your dentist can often recement it with no issue. But if you need to have your bridge removed for another reason — like treating gum disease or underlying tooth decay — your bridge may break during the removal process. If this happens, you’ll need a new dental bridge.

A note from Cleveland Clinic

Missing teeth leave a gap in your smile and can hinder your ability to chew and speak properly. If you’re missing one to four teeth in a row, a dental bridge could be an option for you. Bridges are typically more comfortable than partial dentures and more affordable than dental implants. If you’re missing teeth, talk to your dentist about replacement options. They can help you find a solution that fits your needs, budget and preferences.